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Pellicano C, Colalillo A, Rosato E. Serum kynurenic acid is lower in systemic sclerosis patients with microvascular damage of hands. Microvasc Res 2023; 148:104537. [PMID: 37030527 DOI: 10.1016/j.mvr.2023.104537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/10/2023]
Abstract
BACKGROUND Endothelial dysfunction occurs early in systemic sclerosis (SSc), leading to tissue hypoxia, vasoconstriction and fibrosis. It has been demonstrated that endothelial cells (ECs) are able to produce kynurenic acid (KYNA) in response to vascular inflammation, due to its anti-inflammatory and anti-oxidants activity. In SSc patients, blood perfusion of hands, assessed by laser speckle contrast analysis (LASCA), correlated negatively with the extent of the nailfold microvascular damage, scored according to nailfold videocapillaroscopy (NVC) classification. Aim of this study was to evaluate the difference of serum KYNA in SSc patients with different stages of microvascular damage. METHODS Serum KYNA was assessed in 40 SSc patients at the enrolment. NVC was performed to evaluate capillaroscopic patterns (early, active and late). LASCA was performed to evaluate mean peripheral blood perfusion (PBP) of both hands and to evaluate the proximal-distal gradient (PDG). RESULTS Median PDG was significantly lower in SSc patients with late NVC pattern compared to SSc patients with early and active NVC pattern [3.79 pU (IQR -8.55-18.16) vs 23.55 pU (IQR 14.92-43.80), p < 0.01]. Serum KYNA was significantly lower in SSc patients with late NVC pattern compared to SSc patient with early and active NVC pattern [45.19 ng/mL (IQR 42.70-54.74) vs 52.65 ng/mL (IQR 49.99-60.29), p < 0.05]. Moreover, SSc patients without PDG had significantly lower serum KYNA than in SSc patients with PDG [48.03 ng/mL (IQR 43.87-53.68) vs 59.27 ng/mL (IQR 49.15-71.00), p < 0.05]. CONCLUSION KYNA is lower in SSc patients with late NCV pattern and without PDG. KYNA may be associated with early endothelial dysfunction.
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Affiliation(s)
- Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy.
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Ruan Z, Li R, Dong W, Cui Z, Yang H, Ren R. Laser speckle contrast imaging to monitor microcirculation: An effective method to predict outcome in patients with sepsis and septic shock. Front Bioeng Biotechnol 2023; 10:1067739. [PMID: 36743655 PMCID: PMC9890168 DOI: 10.3389/fbioe.2022.1067739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/19/2022] [Indexed: 01/13/2023] Open
Abstract
Background: This study examines the microcirculation of patients with sepsis and septic shock using Laser Speckle Contrast Imaging (LSCI) technology, to enhance monitoring and predict outcomes of sepsis and septic shock. Methods: From 01 July 2021, to 31 January 2022, 44 patients diagnosed with septic shock and sepsis were included in the study, their clinical data were collected, and LSCI was used to monitor the mean peripheral blood flow perfusion index (PI). Results: The average peripheral blood flow PI of septic shock patients was significantly lower than that of septic patients, with a cutoff value of 26.25. The average peripheral blood flow PI negatively correlated with acute physiology and chronic health evaluation (APACHE) Ⅱ score (p = .01 < .05), sequential organ failure assessment (SOFA) score (p < .01), and lactic acid levels (p = .01 < .05). We report average peripheral blood flow no correlation with age, mean arterial pressure, body temperature, oxygen saturation, heart rate, and body mass index. There was no correlation with procalcitonin, C-reactive protein (CRP), red blood cell distribution width, or platelet distribution width (p > .05). PI significantly correlated with the group sepsis and septic shock (p < .001, r = -.865). And PI significantly correlated with the outcome or mortality (p = .007 < .05, r = -.398). The ROC curve was calculated for PI and the sensitivity was 81.3%, and the specificity was 75% when PI cutoff value chooses 20.88. Conclusion: LSCI technology successfully detected the fingertip microcirculation of patients with septic shock. LSCI can reliably differentiate patients with sepsis vs patients with septic shock. Additionally, the average peripheral blood PI negatively correlated with APACHE Ⅱ, SOFA score, and lactate acid levels, providing useful and supplementary information for the diagnosis and monitoring of septic shock. Trial registration: Chictr2100046761. Registered on May 28, 2021. Clinical Trial Registration: clinicaltrials.gov, identifier Chictr2100046761.
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Affiliation(s)
- Zhengshang Ruan
- Department of Infectious Diseases, Xinhua Children’s Hospital, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ran Li
- School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Wenwen Dong
- Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhilei Cui
- Department of Respiratory Medicine, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Zhilei Cui, ; Hui Yang, ; Rongrong Ren,
| | - Hui Yang
- School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, Shanghai, China,*Correspondence: Zhilei Cui, ; Hui Yang, ; Rongrong Ren,
| | - Rongrong Ren
- Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,*Correspondence: Zhilei Cui, ; Hui Yang, ; Rongrong Ren,
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Heeman W, Steenbergen W, van Dam GM, Boerma EC. Clinical applications of laser speckle contrast imaging: a review. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-11. [PMID: 31385481 PMCID: PMC6983474 DOI: 10.1117/1.jbo.24.8.080901] [Citation(s) in RCA: 137] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/02/2019] [Indexed: 05/02/2023]
Abstract
When a biological tissue is illuminated with coherent light, an interference pattern will be formed at the detector, the so-called speckle pattern. Laser speckle contrast imaging (LSCI) is a technique based on the dynamic change in this backscattered light as a result of interaction with red blood cells. It can be used to visualize perfusion in various tissues and, even though this technique has been extensively described in the literature, the actual clinical implementation lags behind. We provide an overview of LSCI as a tool to image tissue perfusion. We present a brief introduction to the theory, review clinical studies from various medical fields, and discuss current limitations impeding clinical acceptance.
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Affiliation(s)
- Wido Heeman
- University of Groningen, Faculty Campus Fryslân, Leeuwarden, The Netherlands
- University Medical Centre Groningen, Department of Surgery, Optical Molecular Imaging Groningen, Groningen, The Netherlands
- LIMIS Development BV, Leeuwarden, The Netherlands
| | - Wiendelt Steenbergen
- University of Twente, Techmed Center, Faculty of Science and Technology, Biomedical Photonic Imaging Group, Enschede, The Netherlands
| | - Gooitzen M. van Dam
- University Medical Centre Groningen, Department of Surgery, Optical Molecular Imaging Groningen, Groningen, The Netherlands
| | - E. Christiaan Boerma
- Medical Centre Leeuwarden, Department of Intensive Care, Leeuwarden, The Netherlands
- Address all correspondence to E. Christiaan Boerma, E-mail:
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Ruaro B, Sulli A, Alessandri E, Pizzorni C, Ferrari G, Cutolo M. Laser speckle contrast analysis: a new method to evaluate peripheral blood perfusion in systemic sclerosis patients. Ann Rheum Dis 2013; 73:1181-5. [PMID: 23956248 DOI: 10.1136/annrheumdis-2013-203514] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aim of this pilot study was to assess peripheral blood perfusion (PBP) by a new technique, the laser speckle contrast analysis (LASCA), in systemic sclerosis (SSc) patients showing different patterns of nailfold microangiopathy. Correlations between LASCA and single laser Doppler flowmetry (LDF) analysis were also checked. METHODS Sixty-one SSc patients and 61 healthy subjects were enrolled. PBP was evaluated using LASCA and LDF. Scleroderma patterns and microangiopathy evolution score (MES) were assessed by nailfold videocapillaroscopy (NVC). RESULTS As detected by LASCA and LDF, PBP was lower in SSc patients than in healthy subjects (p<0.0001), showing SSc patients with the 'Early', 'Active' or 'Late' NVC pattern a progressively lower PBP (p=0.04 and p=0.002, respectively). There was a negative correlation between PBP and MES values (p=0.006 and p=0.002 for LASCA and LDF, respectively). A positive correlation was detected between LASCA and LDF values, in all subjects (p<0.0001). However, LASCA evaluates larger skin areas, is significantly less time consuming, is more accepted by patients and shows lower intra-operator variability than LDF. CONCLUSIONS LASCA detected lower PBP in SSc patients than in healthy subjects, and for the first time, LASCA perfusion values were found correlated with progression of NVC patterns of microangiopathy.
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Affiliation(s)
- Barbara Ruaro
- Research Laboratory and Academic Unit of Clinical Rheumatology, Department of Internal Medicine, University of Genova, , Genoa, Italy
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